Questions Regarding Chemo & Surgery

We aren't quite at that point yet Mike. Mom is having chemo treatment prior to surgery. The chemo will go for four cycles, lasting about four months. Once the chemo is done, she'll have a 6-8 week recovery/rebuilding of strength period - and THEN the surgery. So we aren't looking at surgery until after the first of the year. The "teach" yesterday that mom and my 3 siblings attending was regarding the chemo - the drugs they will use, possible side effects, length of treatment, the schedule and to answer any questions we might have. Then a tour of the chemo area and finally, we got the appointments for August scheduled.

So that's where we are now. I do realize that they come up with a chemo treatment on a person-by-person basis, taking into consideration, their age, mental capacity, and physical condition. Blood work before each treatment session will be done to see how things look and to ensure whether things need to be tweaked or not.

Certainly is a lot involved. We begin chemo on Monday. Thanks for the info. Doesn't hurt to look ahead to the surgery and you are correct, we do NOT want ANY surprises! - mary

Your mom will probably get the ileal conduit. This is said to be the easiest operation and the most popular for elderly patients. There are quite a number of cancer survivors here who have had this operation and now have the stick-on bag. I’m glad that she is scheduled for the teach in. I did not feel that I was properly prepared to deal with the stick-on bag. I was, without reason, intimidated by the stoma that permanently sticks out of my abdomen. After a while selecting the right style of bag and installing it so it doesn’t leak became a simple do it your self-procedure. We are here to smooth out the little after surgery troubles.

Thanks Mike - You answered some of my questions or at least gave me a few things to think about. We have the "teach" this morning at 10am to meet the team who will be giving mom (ha! at first i wrote "US")the chemo. In a way, this is happening to all of us. I'm glad I found this forum. I think it's going to help me a lot as we go along this path. Mary

Mary,

I don't think a doc would recommend it if he thought it wouldn't work or she couldn't handle it. I'm sure they'd monitor as well and change the plan if needed or recommend to your mom to change the plan.

Chemo on T3 is certainly the standard protocol. Then, I'm not so sure removal is absolute at that point. Not because it would be "cured" by the chemo, but because it might not really be worth it at that point. A lot depends on how effective the chemo is and if there are any signs of metastasis. If there are mets or if the chemo isn't effective "enough" (in the judgement of her docs), then why go through all of the surgery. However, things could go very well and it could make sense to do the cystectomy.

The tricky part of "Prepare for the worst, hope for the best, and be happy to get something in between" is, for cases like this, figuring out what the best and worst are because there are so many variables.

There is risk to the surgery and being older (and I recall you using he word "frail" before) makes it even harder. Being prepared for and dealing with an ileal conduit or Indiana Pouch diversion may or may not be really difficult.

Sorry to be talking in circles. The reason they would take the bladder out after the chemo is that if the bladder is still there, the cancer is going to come back. The damage to the DNA has been done and the chemo doesn't reverse that.

Mike

<strong>"she encourages her children (four of us) to "be cheerful," and I'll dig deep inside myself to ensure she always sees that cheerfulness when she is around me."</strong>

Mary, That is just beautiful.

Mark

Thank you Mark - I guess there will always be questions. And if it weren't for the fact that otherwise, Mom has no health issues except some back problems - maybe this wouldn't be such a hard decision for her. She still drives, lives alone, quilts, is politically active, is involved in teacher's issues (being a retired teacher) and can run circles around me on her computer. I think she feels like she's strong enough so that even the chemo won't be that bothersome, but I'm not sure what her reaction will be when she becomes so weak or fatigued from it that she can barely do for herself, which is what the oncologist said it COULD be like towards the end of the 16 weeks.

We go tomorrow for the "teach." She had me send her links yesterday to the meds they would give her so she could look them up online to see possible side-effects. She's told me she isn't afraid of dying - but only wants make the most of what life she has left, be it by going through the chemo and surgery or by doing nothing at all.

Thanks for sharing your story. I suppose we'll see what we learn. I'm pretty sure that now that she has the port in her that she'll at least start the chemo and just decide week by week if she wants to continue or feels it isn't worth the agony just to prolong by a bit what will happen eventually anyways.

The sad thing is that she watched her sister die from what began as bladder cancer. Her sister had the chemo - the surgery - then the two of them cruised around Europe. Eventually, the cancer spread to her bones which ended her life. My mother would agree with you about how cruel cancer can be. I've always prayed that if she had to die, it would be from almost anything other than this My heart just aches - she encourages her children (four of us) to "be cheerful," and I'll dig deep inside myself to ensure she always sees that cheerfulness when she is around me. I feel like such a little girl again sometimes. This will surely be the most difficult time of my life.

Mary